Prepared rehmannia (Shu Di Huang) Cornelian cherries (Shan Zhu Yu) Yam (Shan Yao) Water plantain (Ze Xie)

Chinese: 六味地黄丸

Pinyin: Liù Wèi Dì Huáng Wán

Other names: Six-Ingredient Pill with Rehmannia, Rehmannia Six Combination

Number of ingredients: 6 herbs

Formula category: Formulas that nourish Yin and tonify

Conditions for which it may be prescribed: CataractGlaucomaHyperthyroid and twenty two other conditions

Main actions: Nutritive tonic for the Liver and Kidney Yin Essence (nourishes the parasympathetic nervous system)

Contraindications: Contraindicated for patients with weak digestion or Yang Deficiency.

Source date: 1119 AD

Source book: Craft of Medicinal Treatment for Childhood Disease Patterns

Liu Wei Di Huang Wan is a 6-ingredient Chinese Medicine formula with Prepared Rehmannia (Shu Di huang) as a principal ingredient.

Invented in 1119 AD, it belongs to the category of formulas that nourish Yin and tonify. Its main action is that it nutritive tonic for the Liver and Kidney Yin Essence (nourishes the parasympathetic nervous system).

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Liu Wei Di Huang Wan is used by TCM practitioners to fight patterns like Blood Deficiency, Yin Deficiency or Liver Yang Rising. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as late menstruation, menopausal syndrome or irregular menstruation for instance.

On this page, after a detailed description of each of the six ingredients in Liu Wei Di Huang Wan, we review the patterns and conditions that Liu Wei Di Huang Wan helps treat.

The six ingredients in Liu Wei Di Huang Wan

Shu Di huang is a king ingredient in Liu Wei Di Huang Wan. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Prepared Rehmannia (Shu Di huang)

Part used: Prepared dried root tuber

Nature: Warm

Taste(s): Sweet

Meridian affinity: KidneyLiver

Category: Tonic herbs for Blood Deficiency

In general Shu Di huang's main actions are as follows: "Tonifies the Blood. Tonifies the Yin of the Kidneys."

In the context of Liu Wei Di Huang Wan, it is used because it strongly enriches the Kidney Yin and Essence.

Learn more about Prepared Rehmannia (Shu Di huang)

Shan Zhu Yu is a deputy ingredient in Liu Wei Di Huang Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Cornelian Cherries (Shan Zhu Yu)

Part used: Dried ripe sarcocarp

Nature: Warm

Taste(s): Sour

Meridian affinity: KidneyLiver

Category: Herbs that stabilize and bind

Shan Zhu Yu nourishes the Liver and restrains the leakage of Essence. It performs the latter function by inhibiting the improper dispersion and drainage through the Liver, thereby enabling the Essence to build up in the Kidneys. For this to occur, a substance with the strong, Essence building properties of the key herb (Prepared rehmannia) is also required.

Learn more about Cornelian Cherries (Shan Zhu Yu)

Shan Yao is a deputy ingredient in Liu Wei Di Huang Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. Yam (Shan Yao)

Part used: Dried rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: KidneyLungSpleen

Category: Tonic herbs for Qi Deficiency

Shan Yao stabilizes the Essence by tonifying the Spleen. Indeed, to reinforce Essence and improve its function, the Spleen (the source of postnatal Essence) must function properly.

Learn more about Yam (Shan Yao)

Ze Xie is an assistant ingredient in Liu Wei Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Water Plantain (Ze Xie)

Part used: Dried tuber

Nature: Cold

Taste(s): Sweet

Meridian affinity: BladderKidney

Category: Herbs that drain Dampness

Ze Xie clears and drains the overabundance of Kidney Fire. It is used here to prevent the rich, cloying properties of the key herb (Prepared rehmannia) from congesting the mechanisms of the Kidneys, which would induce even more Heat from Deficiency.

Learn more about Water Plantain (Ze Xie)

Mu Dan Pi is an assistant ingredient in Liu Wei Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Mudan Peony Bark (Mu Dan Pi)

Part used: Root barks

Nature: Cool

Taste(s): BitterPungent

Meridian affinity: HeartKidneyLiver

Category: Herbs that cool the Blood

Mu Dan Pi clears and drains Liver Fire and is used here to counterbalance the warm properties of Cornelian cherries (Shan Zhu Yu).

Learn more about Mudan Peony Bark (Mu Dan Pi)

Fu Ling is an assistant ingredient in Liu Wei Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

6. Poria-Cocos Mushrooms (Fu Ling)

Part used: Dried sclerotium

Nature: Neutral

Taste(s): Sweet

Meridian affinity: HeartKidneyLungSpleen

Category: Herbs that drain Dampness

Fu Ling is a bland herb that leaches out Dampness from the Spleen. It notably helps Yam (Shan Yao) strengthen the transportive functions of the Spleen. This prevents the formula from clogging up the digestive process and reinforces the Spleen's function of nourishing the body. Poria-cocos mushrooms also works together with the Water plantain (Ze Xie) to improve the metabolism of Fluids and promote urination, thereby preventing a buildup of stagnant Fluids.

Learn more about Poria-Cocos Mushrooms (Fu Ling)

Conditions and patterns for which Liu Wei Di Huang Wan may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Liu Wei Di Huang Wan is used by TCM practitioners to treat twelve different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Late menstruation Menopausal syndrome Irregular menstruation Menstrual cramps Absence of menstruation Intermenstrual bleeding Chronic nephritis Prostate diseases Chronic glomerulonephritis Urinary tract infection Renal tuberculosis Diabetes mellitus Hyperthyroid Diabetes insipidus Hypertension Atherosclerosis Coronary artery disease Perimenopausal syndrome Abnormal uterine bleeding Cataract Glaucoma Central retinopathy Optic nerve atrophy Optic neuritis Retarded growth in children

Again it wouldn't be correct to say "Liu Wei Di Huang Wan treats late menstruation" for instance. Rather, Liu Wei Di Huang Wan is used to treat patterns that are sometimes the root cause behind late menstruation.

Now let's look at the twelve patterns commonly treated with Liu Wei Di Huang Wan.

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Deficiency

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Blood Deficiency. This pattern leads to symptoms such as dizziness, scanty periods, amenorrhea and dull white shallow face. Patients with Blood Deficiency typically exhibit choppy (Se) or fine (Xi) pulses as well as Pale, thin and slightly tongue .

A Deficiency of Blood occurs when their entire body, a part of body or a particular Organ is insufficiently nourished by Blood. This can be caused by a loss of blood, insufficient Spleen Qi to produce Blood or congealed Blood which prevents new Blood from forming.

The Organs most likely to be... read more about Blood Deficiency

'Deficient' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Deficiency / Empty in Chinese Medicine

Yin Deficiency

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Yin Deficiency. This pattern leads to symptoms such as five palm heat, thin body, sore throat at night and thirst. Patients with Yin Deficiency typically exhibit rapid (Shu) or empty (Xu) pulses as well as Red or normal color without coating or with a thin shiny tongue body.

In the case of Yin Deficiency, the body is lacking in its cooling, moistening and nurturing aspects. This leads to Heat and Dryness accompanied by weakness and lack of strength and resistance. The Heat of the Yang gets more obvious because Yin is lacking and it cannot control Yang. Fire gets out of... read more about Yin Deficiency

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Yang Rising

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Liver Yang Rising. This pattern leads to symptoms such as headaches, dizziness, tinnitus and deafness. Patients with Liver Yang Rising typically exhibit wiry (Xian) pulses as well as Pale, normal or slightly red on the sides with no coating.

Long term Deficiency of Liver Yin, Liver Blood or Kidney Yin can cause Liver Yang rising upwards. This pattern is also called "Arrogant Liver Yang". If left unchecked for many years, it can lead to Liver Wind Agitating Internally

The symptoms mentioned here are fairly similar to these of Stagnant... read more about Liver Yang Rising

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney Yin Deficiency With Empty-Heat Blazing

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney Yin Deficiency With Empty-Heat Blazing. This pattern leads to symptoms such as malar flush, restlnessness, insomnia and night sweats. Patients with Kidney Yin Deficiency With Empty-Heat Blazing typically exhibit rapid (Shu), empty (Xu) or floating (Fu) pulses.

This pattern is when Kidney Yin Deficiency, because of the depletion of Fluids and Essence (both Yin in nature), has given rise to pronounced Empty-Heat with symptoms such as night sweats, thirst, five palm heat, dry throat at night, scanty urine and dry stools.

The afternoon fever is typical of... read more about Kidney Yin Deficiency With Empty-Heat Blazing

The Interior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Interior in Chinese Medicine

Interior Wind

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Interior Wind. This pattern leads to symptoms such as convulsions, tremor of limbs, dizziness and paralysis. Patients with Interior Wind typically exhibit fine (Xi), rapid (Shu) or wiry (Xian) pulses.

Interior Wind is mostly referred to be the Liver Wind. There are 4 types of Interior Liver Wind due to the original causes:

1. Liver Wind agitating Internally due to Liver Fire

2. Liver Wind agitating Internally due to extreme Heat

3. Liver Wind agitating Internally due to Liver Yang Rising

4. read more about Interior Wind

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Kidney and Liver Yin Deficiency

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney and Liver Yin Deficiency. This pattern leads to symptoms such as dizziness, tinnitus, diminished hearing and lower back pain. Patients with Kidney and Liver Yin Deficiency typically exhibit empty (Xu) or floating (Fu) pulses as well as Normal-coloured without coating or with rootless coating.

The Liver stores Blood while the Kidneys store Essence.

Liver Blood depends on Essence for nourishment, while Essence depends on Blood for replenishment. Both have a common source: Grain Qi derived from the Spleen. In terms of Five Elements, the Kidneys nourish the Liver.

A long term Liver Blood... read more about Kidney and Liver Yin Deficiency

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Wind agitating Internally due to Liver Yang Rising

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Liver Wind agitating Internally due to Liver Yang Rising. This pattern leads to symptoms such as tremor, facial tic, severe dizziness and tinnitus. Patients with Liver Wind agitating Internally due to Liver Yang Rising typically exhibit rapid (Shu), empty (Xu), wiry (Xian), fine (Xi) or floating (Fu) pulses as well as Red, pale normal color with no coating.

Liver Yang Rising can create Interior Wind if the condition is left unchecked for a long time. This pattern is normally seen among the elderly.

Liver Yang Rising has different symptoms based on what caused it in the first place. If caused by Liver Yin Deficiency the symptoms includes tremors,... read more about Liver Wind agitating Internally due to Liver Yang Rising

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney Yin Deficiency

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney Yin Deficiency. This pattern leads to symptoms such as sweating, back pain, diminished hearing and dry mouth and throat at night. Patients with Kidney Yin Deficiency typically exhibit rapid (Shu), empty (Xu) or floating (Fu) pulses as well as Red tongue without coating, cracked in severe cases.

This pattern often accompanies Kidney Essence Deficiency, as Kidney Yin includes Essence. When both element are depleted in the Kidneys, not enough Marrow is generated to fill the Brain, thus the symptoms of dizziness, tinnitus, vertigo and poor memory. The dizziness is mild and the tinnitus is... read more about Kidney Yin Deficiency

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Blood and Kidney Yin Deficiency

Pulse type(s): Empty (Xu), Floating (Fu)

Tongue coating: Complete absence of coating

Tongue color: Red

Symptoms: Fatigue Tinnitus Sore back Dizziness Scanty periods Blurred vision Delayed period Dull menstrual cramps Pain relieved with massage

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Liver Blood and Kidney Yin Deficiency. This pattern leads to symptoms such as sore back, scanty periods, dizziness and pain relieved with massage. Patients with Liver Blood and Kidney Yin Deficiency typically exhibit empty (Xu) or floating (Fu) pulses as well as a red tongue with complete absence of coating.

Learn more about Liver Blood and Kidney Yin Deficiency

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Blood and Kidney Essence Deficiency

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Liver Blood and Kidney Essence Deficiency. This pattern leads to symptoms such as no menstruation by 18, lower back pain, fatigue and knee pain. Patients with Liver Blood and Kidney Essence Deficiency typically exhibit deep (Chen) or weak (Ruo) pulses as well as a pale tongue.

Learn more about Liver Blood and Kidney Essence Deficiency

The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine

Disharmony between Heart and Kidneys

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Disharmony between Heart and Kidneys. This pattern leads to symptoms such as dizziness, tinnitus, insomnia and palpitations. Patients with Disharmony between Heart and Kidneys typically exhibit rapid (Shu), empty (Xu), fine (Xi) or floating (Fu) pulses as well as a red tongue.

Learn more about Disharmony between Heart and Kidneys

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Kidney and Liver Yin Deficiency causing Heat in the Blood

Pulse type(s): Rapid (Shu), Empty (Xu), Fine (Xi), Floating (Fu)

Tongue coating: Complete absence of coating

Tongue color: Red

Symptoms: Tinnitus Dizziness Back pain Dark Urine Night sweats

Liu Wei Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney and Liver Yin Deficiency causing Heat in the Blood. This pattern leads to symptoms such as dizziness, tinnitus, night sweats and back pain. Patients with Kidney and Liver Yin Deficiency causing Heat in the Blood typically exhibit rapid (Shu), empty (Xu), fine (Xi) or floating (Fu) pulses as well as a red tongue with complete absence of coating.

Learn more about Kidney and Liver Yin Deficiency causing Heat in the Blood

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